Peripheral Vascular Disorders Flashcards
In Peripheral Vascular Disorders, what happens to the blood flow?
Blood can’t go down in the arteries; Blood can’t go back up to the heart from the veins
What PVD is vaso-oclusive?
Buerger’s Disease
What is the other name for Buerger’s Disease?
thromboangitis obliterans
What is the pathophysiology of Buerger’s
Blockage/obstruction of peripheral arteries (secondary to blood clot) → tissue ischemia + production of lactic acid (pain & inflammation) → tissue necrosis
What is the primary factor of Buerger’s?
Smoking/vaping
Buerger’s is common among ___________ (gender)
males
What are the predisposing factors for Buerger’s
-viscous blood (DM, high cholesterol, dehydration)
-sedentary lifestyle
-constrictive clothing
-OCP meds
-virchow’s triad
Why do oral contraceptive pills (OCP) increase the risk for Buerger’s?
OCP attracts a lot of estrogen → calcium is attracted → fibrinogens are created → clotting factor 1
What is the triad of conditions that increases the chances of getting a clot?
Virchow’s Triad
What are the components of Virchow’s Triad?
Stasis
Hypercoagulation (hereditary)
Endothelial injury (blood vessel)
What are the clinical manifestations of Buerger’s?
- cold extremity on the affected portion
- poor wound healing (risk for infection and gangrene)
- pulselessness
- pulse deficit
- muscle wasting/atrophy
- dry ulcers
- hair loss
- ischemic pain
- altered sensations
What is the cardinal sign for Beurger’s?
Intermittent Claudication
What is Intermittent claudication?
Pain on the legs while walking or moving; relieved by rest
What are the diagnostic tests for Buerger’s?
Arteriogram
Doppler UTZ
Tests ending in -gram include what dye?
Iodine dye
What needs to be checked before giving tests that include iodine dye?
Kidney function (iodine dye is nephrotoxic)
Tests that use iodine is contraindicated with the use of what drug?
Metformin (metformin + iodine = lactic acid; more pain)
In Buerger’s, which should be given first, thrombolytics or anticoagulants?
thrombolytics should be given first since a blood clot is already present (dissolve), anticoagulants are given after to prevent the clot from forming again
How should the extremity be positioned for a patient with Buerger’s Disease?
Affected area should be BELOW heart level
BEST POSITION: Semi-Fowler’s
What PVD is vasospastic?
Raynaud’s Disease
Raynaud’s is common in ___________ (gender)
females
What is the pathophysiology of Raynaud’s?
Vasospasm of the peripheral arteries → tissue ischemia + production of lactic acid (pain & inflammation)
Is necrosis present in Raynaud’s? why/why not?
Necrosis is absent in Raynaud’s since there is no complete obstruction of blood flow
What is the primary factor for Raynaud’s?
Cold exposure
What are the predisposing factors of Raynaud’s?
- cold exposure
- stress
- smoking/vaping
- SLE, RA, scleroderma (autoimmune)
What is the drug of choice for all autoimmune disorders?
corticosteroids
What are the clincial manifestations of Raynaud’s?
- common site affected: fingers and toes
- ischemic pain
- poor wound healing
- pulse deficit
- has bilateral and symmetrical effect (both hands and feet)
- cold extremities
- warm extremities
In Raynaud’s, cold extremities happen during what phase?
White/Blue
In Raynaud’s, warm extremities happen during what phase?
red phase
WOF: ________________, during the red phase
orthostatic hypotension (postural hypotension)
What is the cardinal sign for Raynaud’s?
Progressive Color Shifting (fingers & toes)
White → Blue → Red
What are the diagnostic test for Raynaud’s?
- Ice water test
- Arteriogram
- Doppler UTZ
In Raynaud’s, vasodilators should be given during what phase?
White/Blue
How should the patient’s affected extremity be positioned in Raynaud’s?
Below heart level
